The URL can be used to link to this page

Home My WebLink About97-7281 BUILDING PE,RMIT ".-- CITY OF ZEPHYRHILLS (813) 788-6611 7281 ;J( :3~ Date/:L-~- 71 ~~CA~sewerconn Water Conn: Permit Property Owner: Job Address: Parcell.D. # ~5 ~~~;~~Ai;? P~ ~. - . ~. ~~- r#!0Ii~' B~- Water Meter: T,I.F.'s: Zoning: Description of Work FINAL 8 NO OCCUPANCY BEFORE C.O. DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector City License Registration # State Certified License# I>?~ -... ~.o Permit Fee - S;gnaMe ~.?L= Company _-__' Address Telephone# Valuation or ~ ~ Contract Price .-:?, /J n n"" / Ftr. Pre SLB Lintel FRM. Insul. CL WL ~., Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final Driveway REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons. a charge of Fifteen and 00/100 Dollars ($ H:;.60l shall be made for each trip for each trade: ~ e7t) a. b. C. d. e. f. g. Wrong Address Condemned work resulting from faulty construction. Repairs or corrections not made when inspection called. Work not ready for inspection when called. Permit not posted on job site. Plans not at job site. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. ~.-....,.-'" "\. ,... '...,...,....,-,~, ....""""'p~' p~.,.". n'T1~, ~,_ _-.....', -.,.,. _'_"'" ,Kinsey Central Heat & Air-Conditioning P.O. Box 2209 Zephyrhills, Florida 33539-2209 (813) 782-2300 ADDRESS CllY , " 7-~f- " / Mooel - NATURE OF .--'\., SERVICE ......" REQUEST QUAN, PART NO. t ~ DESCRIPTION / ...- . "'l SERVICE PERFORMED 7~~1 OAlf COMPLETED CASH :~... r-l i . DATE PROMISED APARTMENT ,t;. o ESTIMATE o CASH o CHARGE ; " PRICE AMOUNT ( TOTAl IIATERIAl TECItlIICAl IlEIMCf TIME TAX TOTAL -- ! - -' ----- ,~ 'J . <-, ' "::;'=-'11' / CUST6MER'S SIGNATURE ,) ~/ " ./ 1--' TECHNICIAN APPLICATION FOR PERKlT CITY OF ZEPHYRBILLS BUILDING DEPARTMENT JOB ADDRESS 19~ ~h1:/h - -5 9 it ?r4r?~..vef1- CI> .>--::< 5 -;; Cf S:I--, PHONE '7&0- 7~5-/ OWNER · S NAME OWNER' S ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D.' (OBTAIN FROK PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction -"ddition -"Iteration _Repair _Install _Sign _Kove _Deaolish PROPOSED USE: _Single F8Ilily _KIF _' of Units _K/H _ec:-ercial _wdust. _Swill. Pool _Other _Restaurant &: Health Departaent Approval DESCRIPTION OF WORK: ;;? ~ 7bv o/c Cfte--r ~ BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELECI'RlCAL AMP Service Florida Power Corp. W.R.E.C. _KECIIABlCAL $ Valuation of Kechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION COMPANY State Cert. or Regist. f City License Registration . ****************************************** lUJII.DER Signature OTRF.R COMPANY State Cert. or Regist. # Signature City License Registration t ****************************************** /" f"\ COMPANY ;;uejT' C~ ~5 ~_ ) State Cert. or Regist. . City License Registration f ******************************** Eke! /C/~ , r Signature COMPANY State Cert. or Regist. . City License Registration f ****************************************** PLUMBER Signature COMPANY ~ ,V C;~ State Ceri. or Reg st. f: City License Registration f ****************************************** ()O <;-11:z... / e 4.... APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS rbe undersigned und.r.t.nd. tl.t thi. per.it ..y be .nlleet tn 'deed restrictlnn.' wlie! say he .... restrictl.. !ban City r.gul.ti.... nb. Und.r.igned ass.... r..ponnlllllty lor COopII.... with any .pplicabl. deed r..tricti.... B. UNLICENSED CONTRACTORS ANU CONTRACTOR RESPONSIBILITIES If the ....r I" Ilred · contr'cIor or contr.ctor. tn nnd.rtal. ..rl. !bey..y be regaired tn be II....ed In 'ccordance will .t.t. and loc.1 regulati.... If tbe contractor I. not lic"'ed " regulred Iy I... loll the ..... and conlIactor say be cited fnr a .iodeoeannr 'inlatinn under .tat. I... If tl. ....r or intend.d cootractor are uncertain" to IIot li....lng regalr....ts ..y .pply for th. Int.nded unrl. th.y .r. ad,ised to coot.ct th. City of Zeplyrhlll. BDlldIog Deparlleot. rill) 788-6611. Furthenoor.. If tl. ....r !as lired a contractor or contractors. I. i. ad,i.ed to 10,. the contractorr.) .Ign portl... of the 'Contractor Socti...' of thi. application for wllcl th.y will be respon.III.. If YOU. a. the "'er .ign " the contractor. you are indicating that you. ralbor llon tl. contractor. are responsibl. for lb. IOrl. ff tbe contractor .i8lo. yo. to .Ign .. cootractor that ..y be ao indiration !bat b. i. not properly licen.ed and I. oot entitled to persfttiog priYileges 10 the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND U1'ILITY CONNECTION FEES D. CONSTRUCTION LIEN LftW (CIIAPTER 713. FLORIDA STATUTES, AS AMEliDED) I certify th.t I. lb. applicant. love I.en provided with. COpy of 'Florida'. COnstructi.. Lien Lao _ BOIeoIoer'. Protectl.. Goid.' prepared by the Florid. Deparlsent of Agricultnr. and C......r Aff.lr.. If lb. applicant i. ....... olbor tIon the 'ONDer'. I certify tlat 110" obt.lned · copy of tl. .bov. described dn<_t .nd Pruolse la good f.ilb to deliver It to the "owner" prior to co..enCelent. " t' . E. CONTRACTOR'S/OWNER'S AFFIDAVI1' I certify tlat .11 the inforoati.. io Ibl. .ppllc.tlno I. aocnr.t. and that .11 worl 0111 be done 10 COIpIlance 0111 .11 applicable lawB regUlating construction, loning, and land develop.ent. I Application I. lereby ..d. to obtalo a P'OIit to do IOrl and instail.tlon " indicated. I certilJ thet no IOrl or IDBtallati.. 10. COIIODced prior to I..uance of a perolt and thet all IOrl oill be perfDrlOd to lOSt .laodards of all I... regulating constructi... City codes. ...ing regulatl.... and land d.,.I",,"t regulati... in the jwrlollcti... I al.. certify !bat I nnder.tand that the regul.ti... of otler go',,",,"tsl agencies ..y apply to the lo!eoded lOll. and !bat it I. .y r","",llillty to id.otify Ob.t .cti... I .u.t tal. to be io COIpliance. Sucb agoneles I,clnds bot are not lisited to: · Oelortoent of An'ir.....tal R...I.tloo - ClPre.. Boyband., Notland Ar... and Ho'ir....ntally Sensiti,. Landa, Nater/Nastewater freablent · Sontboe.t Florid. Bot.r I........t Di'trict - Noll., Cypr... Boyband.. Jeti.nd Areas, Allerlng BolerCODr... t Ar.y Corps of Engineers - Seawalls, Docks, Navigable Naterways · De rlIeot of Heallb , Rehabilitative SOlti", lotir.....t.1 He.lth Unit - Noll.. H..t...ler ""lIeol. Seplic Ian" t US BnviroDlental Protection AgenCl - Asbestos abatelent I .1'0 cerllfy !bat, if fill ..terl.1 I. to be used In Flood .... 'A' or 'A..tc.'. it I. underslool lbol . dralnogo pi.. addressing a 'ClIIpeDSating ..I.... om be .uiJlollted Oble! I. prepared Iy . profensl...1 eogi_ regi.lered io the Stats of Florida prior to per.it, issuance. . A peroll iSSued shall !e OOD'lrued to be a lie.... to proceed lith 16. wort and not as an!borlly to ,Iolale. CIDO!I aller, or ..I ..Id. any provi.ions of the l.chalc.1 cod.., nor .ball i"u,"" of . perlll pr....1 lbo B.llding Official f... tIorsatter r.qulrlng a correcli.. oi error. 10 pi.... OUDSlrucliun. or ,iolall... of an, cole. BYery Pl<ait 10I0Sd 1b.11 hecoos Ioralld ,nl... lbo IOrl authorl.ed Iy snch pOllil i. COIIOoced withio .io "'11s of i........ or if lOll authorized by !be perlit I. 8DIpeDded or abandoned for a period of .11 IOJIlbo after the ti.. the worllo COIIOOCed. IlIle 90 dsy OIleasllll of lioo. .., be alllllOd for the per.il lilb fee charg. of 115.00. lb. OII...i.. Iball be r.....ted 10 Illllnq to the BoIIding official. An approved inspection .ust be logged during each six IOntb period, or the project will be considered abandoned. IIAIIIIIIIG YO DIiIIllR: YOIlII FlIILOBIl YO llRCDIUJ A IIDY f CK of CIIIIBlIICBIIUY IlAY IIBSlJLr II YOIlII PAYIIG YIlfCK IDIl iIIFIRMIIIIn8 10 I'lIIR PllDPIfRTT. IF roo IITJDJD YO DllJAII Fl8AIICIIIG. Cl!lISULT Him YOOR LIlIllBR DR All AYTllWY _ RIlllRDllIG YOIlIIIIDrICK of CIIIIIHIICBIIm. - DRm 12,506 II YAW 00 IIDr lUll YO llRCDIUJ AIID FOST A 'IIOYICK DF CIIIIBlIICBmr'. ...... SIG ~ , I srArK FtolnDA COUH1'Y OF The foregoing instrument before me this was acknowledged , 19_ by STAr FLORIDA COUHTY OF The foregoing instrument was acknowledged before me this , 19 by who is personally known to me or who has produced ' as identification and who did/did not take an oath. (Signature) who is personally known to me or who has produced as identification and who did/did not take an oath. (Name Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC